 <style type="text/css">
 
.style-radius {
    border: 1px solid #DDDDDD;
    border-radius: 4px 4px 4px 4px;
}
.article-title-indent {
    background: url("../images/article_title.png") repeat scroll 0 0 transparent;
    overflow: hidden;
    width: 100%;
}
.article-title-indent h3 {
    font-size: 14px;
    font-weight: bold;
}
 </style>
<div class="style-radius">
<div class="article-title-indent png">
<h3 style="padding-left:5px;">Booking <font style="color:#FFF;"><?php echo $_GET['name'];?></font></h3>
</div>
<div style="padding-left:10px;">
<form name="contactform" method="post" action="send_form_email.php">
<table width="450px">
<tr>
 <td valign="top">
  <label for="first_name">First Name <font color="#FF0000">*</font></label>
 </td>
 <td valign="top">
  <input  type="text" name="first_name" maxlength="50" size="30">
 </td>
</tr>
<tr>
 <td valign="top">
  <label for="last_name">Last Name <font color="#FF0000">*</font></label>
 </td>
 <td valign="top">
  <input  type="text" name="last_name" maxlength="50" size="30">
 </td>
</tr>
<tr>
 <td valign="top">
  <label for="email">Email Address <font color="#FF0000">*</font></label>
 </td>
 <td valign="top">
  <input  type="text" name="email" maxlength="80" size="30">
 </td>
</tr>
<tr>
 <td valign="top">
  <label for="telephone">Telephone Number <font color="#FF0000">*</font></label>
 </td>
 <td valign="top">
  <input  type="text" name="telephone" maxlength="30" size="30">
 </td>
</tr>
<tr>
 <td valign="top">
  <label for="comments">Comments <font color="#FF0000">*</font></label>
 </td>
 <td valign="top">
  <textarea  name="comments" maxlength="1000" cols="25" rows="6"></textarea>
 </td>
</tr>
<tr>
 <td>&nbsp;</td>
 <td>
  <input type="submit" value="Send"> 
 </td>
</tr>
</table>
<input type="hidden" name="title" value="<?php echo $_GET['name'];?>" />
</form>
</div>
</div>